Previous research (J. C. Coyne et al., 2001) that showed that marital functioning predicted mortality among patients with chronic heart failure (CHF) led to an examination of whether expressed emotion (EE) captured negative marital influences on patient survival. The authors assessed EE using 5-min speech samples obtained from patients (137 men and 47 women) and their spouses. Prevalence of EE was low, and patient and spouse EE were unrelated. Spouse EE was not associated with survival, after the authors controlled for severity of illness. Among patient EE variables, high EE status predicted survival, but in the opposite direction of what was anticipated. Overall, relations between EE and self-report measures of adaptation were weak and inconsistent. Despite the strength of findings concerning EE and psychiatric outcomes, EE does not show promise in predicting adaptation to CHF, and researchers and clinicians should instead seek to identify positive marital factors that may promote patient survival.